ETHAN TANNER AUSTELL

ST PETERSBURG, FL
NPI1700678778
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: FL  7775)
Enumeration Date2025-05-19
Last Update Date2026-07-01
Business Address
ETHAN TANNER AUSTELL MS, ATC, LAT, CES
850 34TH ST S
ST PETERSBURG, FL 33711-2297
Phone number: 904-607-1418
Mailing Address
ETHAN TANNER AUSTELL MS, ATC, LAT, CES
6815 FOXTAIL PALM WAY APT 109
BRADENTON, FL 34210-7032
Phone number: 904-607-1418
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